Use of Rituximab for persistent EBV DNAemia, and Its effect on donor‐specific antibody development in pediatric renal transplant recipients: A case series
| العنوان: | Use of Rituximab for persistent EBV DNAemia, and Its effect on donor‐specific antibody development in pediatric renal transplant recipients: A case series |
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| المؤلفون: | Elaine S. Kamil, Edmund Huang, Stanley C. Jordan, I. Kim, Nancy L. Reinsmoen, Mitasha Patel, Dechu Puliyanda, Mieko Toyoda, Anand Murthy, Xiaohai Zhang |
| المصدر: | Pediatric Transplantation. 25 |
| بيانات النشر: | Wiley, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Male, Epstein-Barr Virus Infections, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Antibodies, Viral, Gastroenterology, immune system diseases, hemic and lymphatic diseases, Internal medicine, medicine, Humans, Immunologic Factors, Child, Retrospective Studies, Transplantation, business.industry, Donor specific antibodies, Standard treatment, Infant, Immunosuppression, Valganciclovir, Viral Load, Kidney Transplantation, Lymphoproliferative Disorders, Renal transplant, Child, Preschool, DNA, Viral, Pediatrics, Perinatology and Child Health, Female, Rituximab, business, Viral load, Clearance, medicine.drug |
| الوصف: | Introduction Persistent EBV DNAemia (PEBV) is associated with late-onset PTLD. The efficacy of rituximab in PEBV is not conclusive. We monitored PEBV and DSA in pediatric kidney transplant patients with or without rituximab. Methods 13 PEBV patients received standard treatment with immunosuppression reduction and valganciclovir, with or without IVIG; 5/13 were further treated with rituximab. Results All Rituximab-treated and 6/7 No-Rituximab patients were EBV seronegative at transplant and seroconverted post-transplant. Peak EBV PCR levels were lower in No-Rituximab than Rituximab patients and all No-Rituximab patients cleared PEBV after standard treatment. Additional 1-2 doses of rituximab reduced EBV PCR levels in all 5 Rituximab patients, 3 cleared PEBV. One No-Rituximab patient developed localized PLTD. None of Rituximab patients developed de novo DSA, while 4/8 No-Rituximab patients did: 2/4 had ABMR. 1/5 Rituximab and 5/8 No-Rituximab patients had acute rejection. There was no change in eGFR between pre-EBV DNAemia and follow-up in Rituximab patients, while reduction in No-Rituximab patients was found. There was no difference in graft and patient survival. Conclusions While early intervention with rituximab in pediatric patients with PEBV may reduce viral load and PTLD, we observed a slower development of de novo DSA, and rejection and maintenance of eGFR. |
| تدمد: | 1399-3046 1397-3142 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::238cc12ae6b86b41e53074c2160b4e02 https://doi.org/10.1111/petr.14113 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....238cc12ae6b86b41e53074c2160b4e02 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 13993046 13973142 |
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